Traumatic brain injury

Specialist: It’s more prevalent than people would think

February 4, 2013

You're walking out of the grocery store, not thinking about anything in particular and not really noticing anything out of the ordinary, when all of a sudden your foot slips on a patch of ice and you're on the ground. Your feet have slipped right out from under you, you've landed on your back and you've hit your head. Even though you feel OK and you can get back up, you may have experienced a traumatic brain injury.

Traumatic brain injury occurs when an external force traumatically injures the brain that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities and/or physical functioning. It's the second most prevalent injury and disability in the U.S. More than 50,000 people die every year as a result of a traumatic brain injury. One person sustains a traumatic brain injury every 23 seconds and each year 235,000 people are hospitalized with one.

According to Justin Boseck, neuropsychology resident and certified brain injury specialist with Trinity Health, falls are the No. 1 cause of traumatic brain injury. With baby boomers getting older, they're falling more, he said, in addition to the already-frequent falls of little kids in the 0- to 4-year range. Motor vehicle accidents are the second leading cause of traumatic brain injury.

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Jill Hambek/MDNJustin Boseck, neuropsychology resident and certified brain injury specialist with Trinity Health, demonstrates how playing chess helps assess a patient’s status and recovery with a traumatic brain injury. Chess is good for determining a patient’s organizational skills, Boseck said, and also helps to open up dialogue with patients during a game.

Other causes of traumatic brain injury include gunshot wounds, sports injuries, workplace injuries, shaken baby syndrome, child abuse, domestic violence and military actions. The Centers for Disease Control said that traumatic brain injury can cause a wide range of functional short or long term changes affecting thinking, sensation, language and emotion. It can also cause epilepsy and increase the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more prevalent with age.

With some brain injuries, the memory to do certain everyday tasks is affected, Boseck said. For example, a person who had experienced a traumatic brain injury would try to dress himself and then not remember what step comes next. A closed-head injury is worse than getting a penetration injury, he also said, because the whole brain is impacted instead of just the part where the object entered the brain.

Boseck worked in cognitive rehabilitation for a year, which is individual-based according to each person's level. It focuses on retraining the person's brain in attention, memory and problem solving type of therapy. Treatment for traumatic brain injury involves cognitive therapy and medication. However, Boseck said they don't want to throw a bunch of chemicals into an injured brain; as much spontaneous recovery as possible if preferable. What you see in recovery about six months after the injury is what you're most likely going to get, he noted.

Also very important in treatment of traumatic brain injury is family therapy.

"There's a high rate of divorce, because often times the person changes after a brain injury and it's a tough road," he said.

Some ways to prevent traumatic brain injury, according to Boseck, are to be more careful; don't put yourself in dangerous situations; get better helmets for sports teams; educate more; do a better job of assessing older people after a fall; and try to keep up with infants as best as you can to make sure they don't fall.

"The best way to prevent it is to educate, but there's very little you can do to prevent it," he added.

One thing to note is that after one traumatic brain injury, the risk for a second injury is three times greater, Boseck said. After the second injury, the risk for a third injury is eight times greater.

"It brings about the 'chicken or the egg' theory," he continued. "Are people putting themselves in more dangerous situations, or does the brain injury affect their judgment somehow?"

Traumatic brain injury is much more rampant than you would think, Boseck said, and also less-reported by the media.

"A lot go unnoticed because you can hit your head and go on and think all is fine," he added. "It is a major problem, and as more education gets out there, people will become more aware of brain injuries."

Boseck said that there's better recognition now of traumatic brain injury, but it has always been there.

"I think because of increasingly faster technology, people are increasingly putting themselves at risk," he explained. "The human body is not meant to keep up with the fast pace."

"Traumatic brain injury is a lot more prevalent than you'd imagine. It doesn't just happen to football players or veterans, but to everyone," Boseck said. "People need to be aware of the impact of (an injury), and what it is, and how to recognize the symptoms in other people or in a loved one.